<form action="<?php //echo $this->Html->url(array('action' => 'saveOrg')); ?>" method="post" class="form-horizontal">
    <fieldset>
        <legend> Organisational Details</legend>
        <div class="row">
            <div class="span8">
                <div class="control-group">
                    <label class="control-label" for="name"> *Name: </label>
                    <div class="controls">
                        <input class="input-xxlarge" name="name" type="text" name="name"> 
                    </div>
                </div>

                <div class="control-group">
                    <label class="control-label" for="address"> Address: </label>
                    <div class="controls">
                        <input class="input-xxlarge" name="address" type="text" id="address"> 
                    </div>
                </div>

                <div class="control-group">
                    <label class="control-label" for="email"> E-mail: </label>
                    <div class="controls">
                        <input class="input-xxlarge" name="email" type="text" id="address"> 
                    </div>
                </div>
            </div>

            <div class="span2">
                <div class="control-group">
                    <img src alt="passport" width="150" height="150px"/>
                </div>  
            </div>
        </div>


        <div class="row">
            <div class="span3">
                <div class="control-group">
                    <label class="control-label" for="phone1"> Phone 1: </label>
                    <div class="controls">
                        <input class="input-medium inline" name="phone1" type="text" id="number">
                    </div>
                </div>
            </div>

            <div class="span3">
                <div class="control-group">
                    <label class="control-label" for="phone2"> Phone 2: </label>
                    <div class="controls">
                        <input class="input-medium inline" name="phone2" type="text" id="number"> 
                    </div>
                </div>
            </div>  
        </div>

        <div class="control-group">
            <label class="control-label" for="org_type"> Organisation Type </label>
            <div class="controls">
                <select class="input-medium" name="org_type">
                    <option value="1"> Association </option>
                    <option value="2"> Business </option>
                    <option value="3"> Church </option>
                    <option value="4"> Company </option>
                    <option value="5"> Corporation </option>
                    <option value="6"> Institution </option>
                    <option value="7"> School </option>
                    <option value="8"> Union </option>
                </select>
            </div>
        </div>
    </fieldset>

    <fieldset> 
        <legend> Data Collection </legend>
        <div class="row">
            <div class="span10">
                <div class="control-group">
                    <label class="checkbox inline" style="margin-left: 50px;">
                        <input type="checkbox" name="loc_id" value="option1"> Location Identification
                    </label>

                    <label class="checkbox inline" style="margin-left: 50px;">
                        <input type="checkbox" name="user_reg" value="option2"> User Registration
                    </label> 

                    <label class="checkbox inline" style="margin-left: 50px;">
                        <input type="checkbox" name="biodata" value="option3"> Biometric Data
                    </label>

                    <label class="checkbox inline" style="margin-left: 50px;">
                        <input type="checkbox" name="faminfo" value="option4"> Family Information
                    </label>

                    <label class="checkbox inline" style="margin-left: 50px;">
                        <input type="checkbox" name="supdoc" value="option5"> Supporting Documents
                    </label>
                </div>
            </div>
        </div>

        <fieldset>
            <legend> Application Interface</legend>
            <div class="row">
                <div class="span10">
                    <div class="control-group">
                        <label class="checkbox inline" style="margin-left: 50px;">
                            <input type="checkbox" name="orgadmin" value="option1"> Organisation Administration
                        </label>

                        <label class="checkbox inline" style="margin-left: 50px;">
                            <input type="checkbox" name="pay_man" value="option2"> Payroll Management
                        </label>
                    </div>
                </div>
            </div>

            <fieldset>
                <legend> Data Security </legend>
                <fieldset>
                    <legend> Organisation Security </legend>
                    <div class="row">
                        <div class="span3">
                            <div class="control-group">
                                <label class="control-label" for="username"> Username </label>
                                <div class="controls">
                                    <input type="text" name="username">
                                </div>
                            </div>

                            <div class="control-group">
                                <label class="control-label" for="password"> Password </label>
                                <div class="controls">
                                    <input type="password" name="password">
                                </div>
                            </div>
                        </div>
                    </div>
                </fieldset>
            </fieldset>

        </fieldset>

        <div class="form-actions">
            <button type="submit" class="btn"> Submit </button>
            <button type="button" class="btn">Cancel</button>
        </div>
    </fieldset>
</form>